| NPI | 1487301917 |
|---|---|
| Doing Business As | STARLIGHT PROVIDER GROUP, P.C. |
| Entity Type | Organization |
| Authorized Contact | VIKRAM DEEPAK BAKHRU President 888-811-9064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2022-03-04 |
| Last Update Date | 2025-05-30 |